gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Implementation of Guidelines for Management of Community-Acquired Pneumonia (CAP) in 72 French Emergency Departments

Meeting Abstract

  • A. Durocher - Haute Autorité de Santé, Saint Denis, France
  • J. L. Ducassé - Emergency Department-University Hospital, Toulouse, France
  • Y. Claessens - Emergency Department, Cochin University Hospital, Paris, France
  • J. P. Fontaine - Emergency Department, Saint Louis University Hospital, Paris, France
  • M. Borderon - ORUMIP, Toulouse, France
  • V. Vernet-Garnier - Microbiological Department, University Hospital, Reims, France

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP160

DOI: 10.3205/12gin272, URN: urn:nbn:de:0183-12gin2725

Published: July 10, 2012

© 2012 Durocher et al.
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Outline

Text

Background: HAS updated guidelines on ‘Proper use of antibiotics’ and AFSSAPS for CAP management.

Objectives: To assess the conformity of antibiotic (ATB) prescription with national guidelines for CAP in patients in emergency departments (ED)

Methods: Prospective study of the management of CAP with internet checklists

Results: 3,166 adults with CAP were included in 72 representative French ED. An hospitalization occurred in 84.6% (9.3% in ICU), more than expected by guidelines (p=10-4) The following not recommended indicators were performed: blood cultures (54%), Ag S. pneumoniae (25.2%), Legionella (33%) in urines, C reactive protein (84%), procalcitonin (11.3%). 71 % of patients were empirically treated with one ATB. Most of them received ATB by the intravenous route (83%) and within 4 hours of admission to the hospital. The ATB used was amoxicillin plus clavulanic acid (46.5%) or ceftriaxon (28.2%) and was usually not in accordance with guidelines. Combination therapy was prescribed in 28.8% (more than expected by guidelines-p=10-4) There are written antibiotic therapy protocols (60%). The prescription of antibiotics use computerised system (60%) .At least one survey of practices has been carried out on the proper use of antibiotics during the previous year (32%). Physicians have information about the consumption of antibiotics (51%)

Conclusions: the management of CAP in ED was poorly appropriated and there was an excessive hospitalization and ATB combination prescription .Efforts have to be done on protocols and survey of practices